Osteoarthritis (Arthrosis)

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Disease that is characterized by the wear of articular cartilage and bone changes, including osteophytes, commonly known as „parrot beaks”.

What is osteoarthritis?

Osteoarthritis is the same as osteoarthritis, osteoarthritis or degenerative joint disease. In the group of diseases grouped under the name „rheumatisms”, osteoarthritis is the most frequent, representing about 30 to 40% of consultations in Rheumatology outpatient clinics. In addition to this fact, its importance can be demonstrated through social security data in Brazil, as it is responsible for 7.5% of all leave from work; it is the second disease among those that justify the initial aid, with 7.5% of the total; it is the second also in relation to sickness benefits (in extension) with 10.5%; is the fourth to determine retirement (6.2%).

Osteoarthritis (arthrosis), taken together, has a certain preference for women, but there are locations that occur more in females, for example hands and knees, others in males, such as the hip joint (of the femur with the pelvis). It increases over the years, being less common before the age of 40 and more frequent after the age of 60. By the age of 75, 85% of people have radiological or clinical evidence of the disease, but only 30 to 50% of individuals with alterations seen on radiographs complain of chronic pain.

Osteoarthritis (arthrosis) is a disease that is characterized by the wear and tear of articular cartilage and bone changes, including osteophytes, commonly known as “parrot beaks”.

A can be divided into no known cause (said primary) or with known cause (said secondary). The causes of the latter form are numerous, from joint defects, such as knees with deviations in direction (valgus or varus), to changes in metabolism. The participation of heredity is important, especially in certain clinical presentations, such as the nodules of the fingers, called Heberden’s nodules (in the joint of the fingertips) or Bouchard (in the joint of the middle of the fingers).

Exercises and osteoarthritis

It is important to consider two aspects in relation to exercise and osteoarthritis: 1) osteoarthritis as a consequence of physical exercises; 2) participation of exercises in the treatment of osteoarthritis.

The nutrition of a joint depends on its activity within physiological limits. Therefore, the functional activity of a joint is fundamental to your health. Excessive inactivity is clearly harmful.

A joint can suffer from acute or chronic trauma. Chronic trauma corresponds to a repetitive activity that exceeds the joint’s capacity to protect itself, through its satellite muscles, capsule and tendons, causing the cartilage to receive excessive forces that it is not prepared to absorb. There are work and sports activities, mainly in sports that demand a lot from those who practice them, in which the repetitive use of joints is usual and that can determine joint damage. Examples of professions that can lead to osteoarthritis: workers in the textile industry, who have a higher prevalence of Heberden’s nodules (nodes in the fingertips); workers who perform long-term tasks with their knees in flexion, leading to arthrosis of these joints; farmers who frequently have osteoarthritis of the hip (joint of the thigh with the pelvis); mine workers who have knee, hip and spine osteoarthritis.

Elite athletes are at high risk for later development of osteoarthritis in joints that receive a load. Likewise, football players, even those with no history of significant injuries. It seems that runners are at greater risk of developing knee and hip arthrosis late. In elderly individuals without knee arthrosis, followed for 8 years, it was observed that high physical activity correlated with a higher risk of radiological development of that disease. Usual physical activity did not increase the risk of knee arthrosis for men and women.

In assessing the risk that a person has of developing osteoarthritis, through physical activity, it is essential to take into account the conditions of their joint. Normal joints can tolerate prolonged and even vigorous exercise without major clinical consequences, but individuals who have muscle weakness, neurological abnormalities, defective joints (for example, knees with deviations in or out – valgus or varus), significant difference in limb length inferior, hereditary or congenital joint alterations (dysplasias), etc. and who practice excessive exercise that overloads the lower limbs, probably end up accelerating the development of osteoarthritis in the knees and hip. That way, it is important to assess the existence of the abnormalities mentioned in individuals who are willing to perform exercises with overload, in order to guide them, if they exist, to perform physical activities that do not force the joints, such as swimming, cycling, for example. Likewise, this is true for individuals who have suffered ligament, tendon or meniscus damage that are subject to an accelerated development of load bearing joints.

As for the participation of exercises in the treatment of arthrosis, it is enough to emphasize that they are able to improve the functional performance of the joints, reduce the need for the use of drugs, and also have an influence on the general condition of the patient, bringing even psychological benefits, being able to act by modifying possible risk factors for disease progression. Exercises are particularly useful when there is joint instability. The strengthening of the anterior thigh muscles is fundamental and indispensable in the treatment of knee arthrosis. Postural exercises are also of great value. It is necessary to emphasize, however, that the exercises must follow a strict medical evaluation that will serve to indicate what must be done in each case.

Diet help?

In osteoarthritis, the only diet that should be considered is one that aims to reduce weight. In osteoarthritis of the lower limbs, especially the knees, obesity is a causative factor, or, at least, aggravating. Therefore, it is essential to keep the weight within normal limits when the joints that support weight are reached. Preventive reduction in body weight reduces the incidence of knee arthrosis. In the cases already installed, losing weight is a very important indication of treatment. No matter how small the reduction, there will always be a benefit. Losing weight is not easy, but the sacrifice is compensated by relieving symptoms and delaying the progression of the disease.

There is no scientific evidence that any other type of diet has a significant influence on the treatment of osteoarthritis (osteoarthritis).